TL;DR
Scene Size-Up: Initial scene evaluation: safety, MOI/NOI, number of patients, additional resources needed, and C-spine consideration.
Scene Size-Up
Definition
Initial scene evaluation: safety, MOI/NOI, number of patients, additional resources needed, and C-spine consideration.
Step-by-Step Procedure
Protocol steps for scene size-up:
AHA ACLS cardiac arrest algorithm: CPR then rhythm check then shock if VF/pVT then epinephrine q3-5min then amiodarone
Differential Diagnosis
When assessing scene size-up, use structured assessment tools to differentiate between possible causes:
APGAR: Components: Appearance, Pulse, Grimace, Activity, Respiration. Scoring: 0-10 at 1 and 5 minutes, under 7 needs intervention.
SAMPLE: Components: Signs/symptoms, Allergies, Medications, Past history, Last intake, Events. Scoring: Mnemonic for patient history gathering.
Related Procedures
Procedures related to scene size-up in the EMS setting:
- AHA ACLS cardiac arrest algorithm: CPR then rhythm check then shock if VF/pVT then epinephrine q3-5min then amiodarone
- Pediatric weight-based dosing: Broselow tape for length-based weight estimation in emergencies
Key Values & Ranges
Key values and ranges relevant to scene size-up in prehospital care:
| Parameter | Adult | Pediatric |
|---|---|---|
| GCS | 15 is normal, under 8 = severe TBI | modified pediatric GCS for preverbal |
| ETCO2 | 35-45 mmHg | 35-45 mmHg |
| blood pressure | 90/60-120/80 mmHg | 70+(2*age) systolic minimum |
| SpO2 | 95-100% | 95-100% |
Why It Matters
Scene size-up is the first step of every EMT assessment. Tested on NREMT exam.
Related Terms
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